Profitability of Hygienist

Replies to This Discussion

Permalink Reply by Cary Feuerman, DMD on January 10, 2010 at 11:44am

Hi Martin,
As you know, there are a lot of factors that influence the answer to this question. For example, one should consider the type of services and treatments that your hygienist will be providing for the patients (fluoride, whitening, quadrant scaling and root planing under local anesthesia, x-rays). Will your hygienist have a dedicated assistant? Will the hygienist have access to one or two dental chairs? Will the hygienist be responsible for making their own appointments and confirming, or will this be done by a front desk or hygiene treatment coordinator? Does the hygienist have non-salary benefits such as health insurance, paid holiday and vacation time, paid sick days, disability and/or life insurance, retirement funding, uniform allowance, continuing education, etc. From what I have read over the years, in a traditional recall program, hygiene production should be three to four times the salary. But given the variables outlined above, and many others, the compensation and production values range widely. This is an age-old question, and hopefully it will generate some additional comments and thoughts!

Permalink Reply by Tracy Baker on February 8, 2010 at 7:45pm

Hi Martin

A lot depends on whether you set your hygienist up to win or not. So many DDS's hand an RDH an operatory and cross fingers hoping they will produce. Well, an RDH is taught to be a health care provider. And most employee's, given the opportunity, will do as little as possible to still keep their job. (This is well documented.)YOU are the leader, what do you expect from your hygienist is terms of production? Does your hygienist KNOW what the hygiene overhead is? IMHO hour or per dium pay breeds apathy. Develop a hygiene protocol based on best practices and latest research. Tell your RDH what you how you expect your patients to be cared for. Arm your hygienist with an intra-oral camera, laser, good instruments, verbal skills and scripts, someone to chart and clean (producers should produce), visual aids, and pay her commision based on her production. Provide alternative revenue-proceding treatments to offer (Vizilite, Arestin,Sub-g irrigation, MI paste, Incipient lesion/white spot lesion treatments, etc) oral health aids to sell(My chairs typically produces 2 to 3 K per day and only THE BEST care is given to my patients) Pay your hygienist the same way you pay yourself.
Hope that helps.
Tracy

Permalink Reply by Pamela Rachil, RDH, BA on May 23, 2010 at 4:15pm

Both previous posts bring up excellent points. Having been in clinical hygiene for 23 years, I can tell you first hand that my production was determined by 1-the professional support and respect I received from my employer 2-additional sales training to help me think "outside the clinical box" and 3-having the proper tools to work with and the time to educate my patients.

I got so disheartened with clinical practice because when I started in the field, the focus was more about education and the actual needs of the patient. Over the years, I saw this transition to production based solely on volume and offering treatment based on what was covered by the patient's insurance. This is happening all around the country, yet high production doesn't have to be based on volume and this is something where there needs to be a paradigm shift in the way the doctors view the hygiene department AND the entire team.

I've been out of clinical now for 3+ years and work with doctors helping them understand how to support their RDH in not only becoming a higher producing segment of their practice, but I train the doctors and their teams on focusing more on COLLECTING what is in their production pipeline. You can achieve production goals fairly easily, but if those patients are walking out the door without completing payment...well, there goes all your hard work.

The majority of practice management consultants base a team's bonuses on production and that can still leave the doctor without a paycheck! My bonus system is based on total collected. With this focus, the entire team gets on board because the more collected, the higher their bonus. And above all, the doctor is guaranteed to get his own bonus as well. It is a huge motivator for everyone to work together as a team.

So, Dr. Nugiel, even though you are focusing on receivables, what you really want to focus on is "how much of that AR is being collected"? Is your RDH discussing outstanding treatment plans or needed treatment with patients and scheduling them IN HER OPERATORY before they walk up front? All the scheduling should be done in the hygiene op so that when that patient walks up front, the lovely financial consultant only needs to handle payment arrangements (which should be her primary focus, not scheduling)

Having clearly defined roles and systems in place will make everyone in your practice work more efficiently and will result in outstanding profits!

Pamela